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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 05 6 <br />TIME: I 5- CASE #.- 1 6 7 "'C <br />LOCATION (PAR /OPEN SPACE): W a 4, 3 LV C- K-5 <br />A <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park <br />( <br />and Open Space Rules, and/or Section o the E ugene Code, 1971, and/or ORS 47 W . 90 wit, You:_ <br />N-zL(Vr-&V0,1 A-) <br />(Description of the violation.) <br />This restriction of use is effective beginning on l g and shall remain in effect until dX 1 3 1 <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R - you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incid nt. The Division Director maw exclude anwone, other than you and thoseuresentinw testimon from the informal hearin@�. <br />This Notice shall remain in effect pending any requested hearing. <br />�'i ''iiII 11111111poreno!'t, III Ineiiii! Inivin I <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy Public Work- Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev 04/03 <br />Name: Last First Middle <br />DOB: <br />Race/Sex: <br />I C if A-42" <br />Res. Address: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />TVL <br />A <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park <br />( <br />and Open Space Rules, and/or Section o the E ugene Code, 1971, and/or ORS 47 W . 90 wit, You:_ <br />N-zL(Vr-&V0,1 A-) <br />(Description of the violation.) <br />This restriction of use is effective beginning on l g and shall remain in effect until dX 1 3 1 <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R - you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incid nt. The Division Director maw exclude anwone, other than you and thoseuresentinw testimon from the informal hearin@�. <br />This Notice shall remain in effect pending any requested hearing. <br />�'i ''iiII 11111111poreno!'t, III Ineiiii! Inivin I <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy Public Work- Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev 04/03 <br />